Provider Demographics
NPI:1841899887
Name:HOBERG, MARGIE FAYE (NMD)
Entity type:Individual
Prefix:
First Name:MARGIE
Middle Name:FAYE
Last Name:HOBERG
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8706 N 58TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4641
Mailing Address - Country:US
Mailing Address - Phone:479-409-7096
Mailing Address - Fax:
Practice Address - Street 1:15278 W BELL RD STE 103
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3100
Practice Address - Country:US
Practice Address - Phone:602-432-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20-19110207RA0401X, 207RE0101X
AZ20-101102083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine